For the estimated 300,000 to 500,000 people in the United States who are allergic to sesame, the recently introduced Food Labeling Modernization Act of 2015 comes as good news.

Included in the act’s provisions, which primarily seek to give consumers easy-to-understand labels on food so they can make healthy choices, is Section 8, which would require sesame to be placed on the list of major food allergens. That, in turn, would compel the Secretary of Health and Human Services to implement a final regulation no later than three years after enactment for determining how sesame must be disclosed on food labels. Section 9 of the proposed legislation goes one step further and requires that, within three years of enactment, signs listing the major food allergens be placed adjacent to non-packaged foods being offered for sale at retail outlets.

Currently, only what are referred to as the “Big 8” allergens — milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat and soybean — must be listed on food labels in clear, easy-to-understand language. That list hasn’t been updated since 2004. While at that time, the foods on the “Big 8” list accounted for 90 percent of the allergies in the U.S., sesame has increasingly become what many refer to as the “ninth major allergen.”

Some scientists say that the likely reason is that more Americans are eating what could be referred to as “exotic” foods, such as hummus (a popular spread or dip made primarily from chickpeas, which are also known as ganbanzo beans) and halva (a popular dessert in Asia, Africa, and Eastern Europe).

A quick look at recipes for these two foods reveals that they contain tahini, or sesame paste, as a main ingredient. (Other names for sesame and related products are “benne,” “teel,” “gingelly oil,” or “til oil.”) Sesame oil has also become a popular cooking ingredient, and sesame is often used as an ingredient in vegetarian burgers. Why so confusing? The problem with this is that even people who know they’re allergic to sesame don’t always know the other names for it, nor do they know that sesame can be hidden within such vague labeling terms as “natural seasonings” or “spices.”

For example, sesame-based ingredients can turn up in surprising places, such as Brach’s candy corn, which contains sesame oil, and the tortillas in Kashi’s chicken enchilada, which are made with sesame flour, according to a Center for Science in the Public Interest (CSPI) report, “Open Sesame: Why Sesame Must Be Disclosed As an Allergen on Food Labels.” The CSPI report also revealed that of the 19 major food manufacturers in the U.S. that were contacted, only three — Kraft, General Mills, and Mondelēz — voluntarily labeled sesame on their products. And CSPI found that some companies that don’t voluntarily label it will provide information to consumers, but others won’t even respond to requests for sesame information. Petitioning for change In November 2014, CSPI filed a Citizen Petition asking that sesame seeds and sesame products be regulated the same way as other major allergens. The petition includes an appendix with letters from several parents of sesame-allergic children explaining why better labeling is so important for their families. For those with an allergy to sesame, accidentally consuming it can trigger “life-threatening anaphylaxis,” CSPI says. Other symptoms include breaking out in hives, developing a swollen tongue, and having difficulty breathing. In a news release about the petition, CSPI highlighted the case of a 10-year-old boy in Virginia who was rushed to an emergency room after eating a restaurant meal despite his parents getting the assurance of the staff before ordering that the meal contained no sesame seeds. That boy’s father, Brian Heller, launched a petition on Change.org in October 2014 asking the U.S. Food and Drug Administration (FDA) to treat sesame as a major allergen. More than 7,500 supporters have signed it. “Most pre-packaged breads, buns, rolls, bagels and other baked goods do not say anything about sesame on the label,” Heller stated in his petition to FDA. Becoming more common

According to the CSPI report, some physicians have noticed that sesame allergies have become far more common, “even outpacing other common allergic reactions.” Robert Wood, M.D., director of Pediatric Allergy and Immunology at the Johns Hopkins University School of Medicine, is quoted in the report as saying that sesame allergies have probably increased more than any other type of food allergy over the past 10 to 20 years. “They’re now clearly one of the six or seven most common allergies in the U.S.,” he said, adding that “it’s remarkably common to see sesame allergy and to see severe reactions to it.” Wood estimated that, in 2010, sesame was the fourth or fifth most common allergy in his patient population of 4,000 children with severe food allergies. And while food allergies are on the rise generally, he said that the sesame allergy “appears to have increased somewhat more than the others.” A challenging allergy Lynda Mitchell, senior vice president of community services with the Asthma and Allergy Foundation of America, told Food Safety News in an email that a sesame allergy can be very challenging because it is not currently identified as a major allergen. Therefore, under existing labeling law, the Food Allergen Labeling and Consumer Protection Act (FALCPA), it does not need to be listed in plain English on food ingredient labels.

Because of that, she said, sesame can hide in terms such as “natural flavor.” People with a sesame allergy would need to call the product manufacturer to find out whether “natural flavor” contained sesame before purchasing it. “Even traces of an allergen can trigger severe allergic reactions in some people,” Mitchell said, “so it’s important for people with a sesame allergy to know if sesame is in a product, or if a product is made on equipment shared with sesame.” According to the CSPI report, studies show that even amounts as low as 100 mg (approximately 1/50 of a teaspoon) of sesame-derived ingredients can provoke a dangerous reaction, while a 30-mg reactive threshold has been observed in some individuals. Congress is listening Citizen petitions, along with growing consumer concern and awareness about sesame as an allergen, have caught the attention of some members of Congress. In June, U.S. Sens. Chris Murphy (D-CT), Richard Blumenthal (D-CT), and Edward Markey (D-MA) sent a letter to FDA calling for a mandatory labeling rule for products containing sesame, stating that the agency needs to do this to help protect the health and safety of consumers. “Without required uniform labeling of the presence of sesame, consumers with this serious allergy have no way of protecting themselves or their family members from its potentially life-threatening consequences,” the letter stated.

The senators pointed to the lack of FDA rules requiring manufacturers to disclose the possibility that traces of sesame can be introduced through production of an array of food items, and they urged the agency to address this issue as well and come up with wording so consumers can be informed of the possible presence of the allergen.

The letter also asked FDA to consider adding corn and mustard to the list of major allergens. Allergen laws in Canada, the European Union, and Australia require that sesame and sesame-based ingredients be labeled on packaged food. An added push Just this past week, four members of Congress — U.S. Reps. Frank Pallone Jr. (D-NJ) and Rosa DeLauro (D-CT), and U.S. Sens. Richard Blumenthal (D-CT) and Edward J. Markey (D-MA) — introduced the Food Modernization Act of 2015, which includes the provision calling for sesame to be included as one of the major allergens and to be clearly labeled on food items containing it. “The push for sesame labeling is finding supporters in Congress,” Laura MacCleery, CSPI’s chief regulatory affairs attorney, told Food Safety News in an email. She said that the proposed addition of a requirement for sesame labeling is “good news because our estimates are that between 300,000 and 500,000 people in the U.S. have a sesame allergy, which can be life-threatening. Because sesame is not considered a major allergen currently under federal law, but can be hidden in flavorings and thus omitted from the ingredient list, it (the food-labeling act) represents progress.”

As for the fate of the bill, MacCleery said that the organization is working to gather co-sponsors in both the House and Senate.

“Like all legislation, the items in the bill are part of an ongoing conversation between Congress and the federal agencies concerning their priorities,” she said. “We hope that FDA will see the interest in Congress in all these items, including sesame, and order its docket accordingly.” She described the proposed bill as a nice step forward for labeling on many fronts, including pushing the government to require front-of-package labels that would clearly indicate the healthfulness of a food. “Consumers are showing keen interest in healthier products, and better labeling is a natural step in the evolution of the food industry,” MacCleery said. Food labeling reform The goal of the Food Labeling Modernization Act of 2015, according to the sponsors, is to minimize confusing and misleading information that consumers encounter on food packages. It addresses front-of-package labeling, misleading health claims, and requiring updates to the Nutrition Facts label and the ingredient list. “When families make the effort to eat nutritious, healthy food, the labels on food products should help them make the right choices, not confuse or mislead them,” Pallone said, pointing out that healthy eating is especially critical to combating the growing epidemic of childhood obesity. In an effort to help consumers select healthy products, the Act’s signature initiative will direct the Health and Human Services Secretary to establish a single standard front-of-package nutrition labeling system in a timely manner for all food products required to bear nutrition labeling. “When ‘whole grain’ waffles can be made with white flour, and ‘all natural’ ingredients can contain synthetic high-fructose corn syrup, it’s clear our food labels are due for a makeover,” MacCleery said. Go here for a section-by-section breakdown of the bill. (To sign up for a free subscription to Food Safety News, click here.)